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HomeMy WebLinkAbout30933-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30962 Date: 06/03/05 THIS CERTIFIES that the building ADDITION Location of Property: 595 TRACK AVE (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 137 Block 1 Subdivision Filed Map No. Lot No. CUTCHOGUE I~ot 21 (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 1, 2005 pursuant to which Building Permit NO. 30933-Z dated FEBRUARY 1, 2005 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is DECK ADDITION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to TIMOTHY WACKER of the aforesaid building. ( OWNER ) SUFFOLK COUNTY DEPARTMENT OF IIEALTH APPROVi~L ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION N/A N/A N/A Authorized Signature Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 30933 Z Date FEBRUARY 1, 2005 Permission is hereby granted to: TIMOTHY WACKER 595 TP~ACK AVENUE CUTCHOGUE,NY 11935 for : CONSTRUCTION OF A DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES BP# 27406. at premises located at 595 TRACK AVE County Tax Map No. 473889 Section 137 Block pursuant to application dated FEBRUARY 1, Building Inspector to expire on AUGUST CUTCHOGUE 0001 Lot No. 021 2005 and approved by the 1, 2006. Fee $ 150.00 Authorized Signature ORIGINAL Rev. 5/8/02 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL COMPLETION OF THE WORK AUTHORIZED) FULL PERMIT NO. 27406 Z Date JUNE 15, 2001 Permission is hereby granted to: TIMOTHY WACKER 595 TRACK AVENUE CUTCHOGUE,NY 11935 for : CONSTRUCTION OF A DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. at premises located at 595 County Tax Map No. 473889 Section 137 pursuant to application dated MAY Building Inspector. TP~ACK AVE CUTCHOGUE Block 0001 Lot No. 021 3, 2001 and approved by the Fee $ 75.00 COPY Rev. 2/19/98 TO~,~qN OF SOUTHOLD 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY .~[~.~ T~s application m~st be filled in by t~pewriter or it~ aud subn~ttcd to the Building Dcpa~ment with thc following: ho For new building or new use: 1. Final survey of property with accurate location of all buildings, prope~y lines, streets, and unusual natural or topographic features. 2. Final Approval frol'u Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation fi'om Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of l% lead. 5. Cormnercial building, industrial building, multiple residences and sinfilar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Plmming Board Approval of completed site plan requirements. Bo For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: I. Accurate survey of property showing all property lines, streets, building and mmsual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building hlspector shall state the reasons therefor in writing to the applicant. 1. Certificate of Occopancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Sv:immiug pool $25.00, Accessory building $25.00, Additions to accessmy building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Oecupancy- $.25 4. Updaled Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Old or Pre-existing Building: .x/.ate'2 LocationofProperty: 5~S '-~/~ C~/~-~ ~r~U'~ House No. Street Owner or Owners of mrope~y: ~O~t2~ ~&~x qV3 Z /tS3 o Subdivision / Filed Map. (check one) Haft'del Lot: PernfitNo. 3(~ 1~5-~~-~ Date of Permit. ~- / - OS Applicant: ~l:r"kqo-4L'~ Health Dept. Approval: Underwriters Approval: Plmming Board Approx al: Request for: Ten;poraD' Certificate Final Certificate: (check one) /~J~- 40 o~ /' O."/~)/~V~'k~,. - A~_p~ica~ 't~athre co 3 o O/TYO .~.',3A~ K1S GNVq N39OD 'q W3±q~AA FEE: _ _ NOTIFY BL!ILE. ;,~,. 765-1S J2 9 FOR POOFd:"' ,. (- 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY [ REMARKS: [ ] ROUGH PLBG. [ ] INSULATI~ON \ C~ FINAL ] FIRE SAFETY INSPECTION DATE ~'--"" ~- O_~ INSPECTOR FIELD INSPECT%ON REPORT FO[fNDATION ( IST) DATE COMMENTS FOUNDATION ( 2ND ) " " FINAL I INSULATION PER N. Y. STATE ENERGY CODE ADDITIONAL COMMENTS: 'To 4t OF BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: 765-1802 PER]VH~r NO. Exam/ned ,20__ Approved {dv[J~. ,20 o \ Disapproved ~'c ttUIJ.,DIINC/Pl~,lCM, l I AIJPi. A(.;A liON CHECKLIS' Do you have or need the following, before applyin~ Board of Health 3sets of Building Plans Survey Septic Form N.Y.S.D.E.C. Trustees Contact: Mailto: Phone: APPLICATION FOR BUILDING PERMIT Date ,20 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to scl/edule. b. Plot plan showing location of lot and of building~ on'premises, relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building ~ipector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose what-so-ever until a Certificate of Occupar~ ~s issued by the Building Inspector. APPLICATION IS HEREBY MADE to the Building. Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk?ounty, New York, and other applicable Laws, Ordinances or Regulation{s, for the cbnsm.tction of buildings, additions, or alterations or for removal or demolition as heretn described. The applicant ~grees to coinply with all applicable laws, ordinan6~s, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signamr~o~' applica~u or name, if a corporation) (Mailing address of app~'m~t) t State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of pi'emises (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authori~i,~d officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work xvill be done: "' House Number Street CountyTax Map No. 1000 Section Subdivision (Name) Ham~'/'O",te.,~'~o~', f :'~' :.~:d~, ,'.'~A?O~ ~,~uoO i~,','h, · .£ l' r t: o,' :.T~, tO .0/4 Filed Map No. Lot State ex!st!r~g use and occupancy ofprem scs and intended use and occupancy of proposed construction: .t. E!xisdnu use and occupancy %*, ,4. i-' ~ 'aw ,~,, '~ '.~," x' b. intended use and occupanc) ' '" ex, t,-' f~.o..Vv- ',~ . Nature of'.vcrk ,check which applicable): New Building. Repair Removal Demolition Addition Other Work Estimated Cost , .)::) ~ Fee if d'.~ elhng, number of d'4 elling units If garage, number of cars Alteration ~Descnptiom {'to be paid on filing this applicatiom __ l]~ __Number ofd~elhng units on each floor If business, commercial or mixed occupancy, specify nature and extent of each t.vpe o fuse. Dimensions ofex~stmg structures, if any: Front ~\. ~ Rear Height ~ <'h Number of Stories_ I Dimensions of same structure with alterations or additions: Front Depth ~7 (.'_~ r,~ Height Dimensions of entire new construction: Front Height \ ,~ Number of Stories Size of lot: Front I 0. Date of Purchase Rear [O© O C Name of Former Owner 5~. I Rear Number of Stories Rear.~')- , / Depth Depth /c3~ '~ 1. Zone or use district in which premises are situated 2. Does proposed construction violate any zoning law, ordinance or regulation: 3. Will lot be re-graded ~.) cD Will excess fill be removed from premises: ~. Names of O's:ncr of premises -~ rr,, ~,.3c'~-.~(~ q4~'Address~Phone No. Name of.,M-chitect Address Phone No Name of Contractor Address Phone No. 5. Is this properly within I00 feet of a tidal wetland? *YES NO t.~ · W YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 6. Provide sureey, to scale, with accurate foundation plan and distances to property lines. 7. If elevation at any point on property is at 10 feet or below, must provide topographical data on sun'%'. YATE OF NEW YORK~ ~ L~~ being duly sworn, deposes and says that (s)he is the apphcant t~a~ o(~dwMual s~ing con=act) above named, ¢~He~sthe (Contractor, Agent, Corporate Officer, etc.) fsaid owner or owners, and is dui)' authorized to perform or have performed the said work and to make and file th~s apphcanon: ~at all statements contained m this application are true to the best of his knowledge and belief; and that thc work v/ill be :rformed in the manner set forth in the application filed therewith. ,vorn.....~ before ,m.e this ~ ~) Notary Pub ~l~c ~..~- Si~g~arure of Applicant